Yoga is the union with the divine. Though there are different types of yoga, the primary objective of all yoga practices is to ensure an integral health, free from common health problems and stress-related disorders. Sympathovagal balance is the cornerstone of a stable homeostasis. Sympathovagal imbalance (SVI) has been reported to be associated with diabetes, hypertension, heart disease and other metabolic disorders. SVI has been documented to promote degeneration and decay and is the basis of all cause morbidity and mortality. Heart rate and heart rate variability (HRV) are measures of sympathovagal balance or imbalance. Resting tachycardia and decreased HRV are established cardiovascular (CV) risks. Practice of yoga, especially relaxation techniques and slow pranayamas has been known to ensure sympathovagal balance, improve HRV and reduce CV risks. In this review, we discuss the types of yoga, physiological basis of improvement of health in yoga practice, the concept and importance of HRV, attainment of sympathovagal balance and improvement of HRV through practice of yoga.

Background and Aim: Although 6:0 and man-to-man defensive formations in team handball (TH) are widely used, there is little information with regard to their physiological impact. Therefore, the aim of the present study was to examine the acute effect of two simulated games, one using 6:0 and the other man-to-man, on measures of neuromuscular performance in young TH players.
Methods: Eleven TH field players (experience 4.3 ± 0.7 years, training 6.5 ± 1.6 h/week, age 15.1 ± 1.0 years, body mass 73.7 ± 9.7 kg, stature 177 ± 7 cm), all members of an academy of a first league club, played two 20-min simulated matches (separated by 2 weeks). They were tested before and after each match for handgrip strength (HS), squat jump (SJ) and 20-m sprint (0-10 m and 10-20 split time). Two-way ([prematch vs. postmatch] × [6:0 formation vs. man-to-man formation]) repeated measures analysis of variance examined differences.
Results: We observed main effect of match on HS, 20 m sprint and 0-10 split time ( P ≤ 0.037, η2 ≥ 0.37), and of formation on 20 m sprint and 0-10 split time ( P ≤ 0.002, η2 ≥ 0.65). In addition, there was a significant interaction between match and defense formation on SJ and 20 m sprint ( P ≤ 0.047, η2 ≥ 0.34). The formation 6:0 and man-to-man resulted in similar mean (179.8 ± 7.2 vs. 180.0 ± 7.0 bpm) and peak heart rate (193.7 ± 4.6 vs. 196.0 ± 8.8 bpm).
Conclusion: The findings of this study indicate that the choice of a defensive formation in TH may result in different physiological responses that are associated with neuromuscular performance. Knowledge about the physiological impact of each formation can help coaches to optimize the use of the various formations during the game and to use them during training in order to elicit different physiological responses.

Biochemical and anthropometric profile of obese subjects of different Prakriti (Constitution) at Jamnagar District, Gujarat, India

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Hetal Amin, Rohit SharmaDOI:10.4103/2348-8093.155505

Background and Aim: Obesity is the most menacing life-style disorder in Ayurveda and it is equated to Sthoulya. Concept of Prakriti0 (human constitution) can be applied for manifestation and prognosis of diseases. Therefore in this study, we intend to study the biochemical, anthropometric and skin fold thickness parameters of different SharirikaPrakriti (body constitution) in Sthoulya subjects.
Methods:Prakriti of 106 subjects of Sthoulya was assessed as per Prakriti assessment proforma. Vata,Pitta, and KaphaDosha (bodily humors) dominant Prakriti were analyzed according to characteristics found in subjects. Biochemical, anthropometric, and skin fold thickness parameters were measured and interpreted according to individual Prakriti. Biochemical parameters were compared in different Prakriti subjects.
Results: Kapha dominant Prakriti subjects were found to have higher serum levels of cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein and very low density lipoprotein than the other Prakriti. Alkaline phosphatase, serum glutamate-pyruvate transaminase, and serum glutamic oxaloacetic transaminase levels were higher in Pitta dominant Prakriti, but they were within normal range. Subjects with Vata dominant Prakriti had higher serum levels of protein, albumin, and globulin but they were within normal limits. All these parameters were compared with dominant Dosha Prakriti and discussed accordingly.
Conclusion: Dominant Prakriti has influence on biochemical, anthropometric, and skin fold thickness parameters of Sthoulya subjects.

Background and Aim: The potential health risk of the radiofrequency electromagnetic fields which are emitted by mobile phones (MPs) is of considerable public interest. The aim of the present study was to determine the influence of the call with a MP on heart rate variability (HRV) in healthy young male and female subjects.
Methods: Heart rate variability was measured in 100 young healthy subjects of either sex from 5 min continuous recording of heart rate using windows-based HRV analysis system during three conditions: (1) When MP is switched off (Period I) (2) when MP is switched on (Period II) (3) during call on MP for 5 min (Period III).
Results: In female subjects, we found that the time domain parameters like root of the mean of the sum of the squares of differences between adjacent NN intervals, standard deviation of differences between adjacent NN intervals, NN50, pNN50 were significantly reduced during Period II and Period III as compared to Period I. Furthermore, the frequency domain parameters such as low frequency (LF) and LF/high frequency (HF) were significantly increased during Period II and Period III as compared to Period I. Whereas HF was significantly reduced during Period II and Period III as compared to Period I in female subjects. In the male, only NN50 count was significantly reduced during Period II and Period III as compared to Period I.
Conclusion: Increase in the sympathetic tone concomitant with the decrease in the parasympathetic tone was observed during the MP usage in female subjects. However, only the parasympathetic tone may be reduced in male subjects while using MPs.

Background and Aim: Skeletal muscle function is significantly reduced following traumatic muscle injury and complete recovery can take several weeks. Pharmacological agents like nonsteroidal anti-inflammatory drugs have been used to minimize pain and inflammation associated with muscle injury. However, their safety and efficacy to improve muscle repair have been challenged. To that end, safer and more effective treatment options remain to be identified. Accordingly, resveratrol use has numerous health benefits in clinical population. Further, resveratrol has been shown to promote myoblast differentiation in0 vitro, which suggests it could be used to improve skeletal muscle regeneration in vivo.
Methods: Experimental mice received resveratrol supplementation (0.05% wt/wt) 4 weeks prior to injury, which persisted throughout recovery. Muscle injury was induced by injecting a diluted barium chloride solution into the tibialis anterior (TA). Isometric tetanic and twitch torque of the anterior crural muscles were measured prior to the injury and 7, 14, or 21 days postinjury.
Results: Resveratrol supplementation had no effect on preinjury isometric tetanic and twitch torque of the anterior crural muscles. Seven days after injury, tetanic torque production was reduced by 80% compared to preinjury values. Functional and structural recovery steadily improved at 14 days and was completed 21 days after injury. However, resveratrol treatment had no beneficial effects on isometric torque or regenerated fiber area.
Conclusion: Acute, low-dose resveratrol supplementation did not improve functional or structural recovery of regenerating mouse TA after injury. Further research is likely required that explores alternate resveratrol dosing strategies and their effects on skeletal muscle repair processes.

Background and Aim: Polycystic ovary syndrome (PCOS) due to its constant association with obesity poses a significant cardiovascular (CV) risk. Heart rate variability (HRV) has been a noninvasive marker of autonomic dysfunction and CV risk. This study was designed to assess the nonlinear dynamics of HRV using Poincare plot in patients with PCOS and elucidate its importance in predicting the CV risk.
Methods: A total of 45 women with newly diagnosed PCOS and 45 controls were recruited for the study. Waist-hip ratio, body mass index (BMI), basal CV parameters such as basal heart rate (BHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were recorded. HRV analysis was done using both linear (time domain and frequency domain) and nonlinear measures (Poincare plot).
Results: The cases had increased basal heart rate, BMI, SBP, DBP, MAP, and RPP. In linear measures of HRV, the total power (TP), which depicts overall HRV was reduced, and the ratio of low-frequency to high-frequency (LF-HF) was significantly increased in cases. In nonlinear measures, the standard descriptors (SD1 and SD2) and area of the ellipse (S) were decreased, which signifies decreased HRV. There was a significant correlation of linear measures (TP, LF-HF ratio) and nonlinear measures (SD1, SD2, S) with elevated RPP. Both linear and nonlinear measures had independent contribution to elevated RPP, observed from regression analysis.
Conclusion: Decreased HRV and autonomic dysfunctions in the form of increased sympathetic drive and decreased vagal activity were observed in PCOS patients that may herald CV risks. Poincare plot analysis can independently quantify the magnitude of autonomic dysfunction in PCOS.

Background and Aim: It is a well-known fact that traffic policemen in Delhi are exposed to immense vehicular pollution particularly at crowded intersections. These pollutants affect various systems of the body including nervous system in due course of time. Realizing these facts, we recorded absolute and inter peak latencies (IPLs) of brainstem auditory evoked potentials (BAEPs) in traffic policemen exposed to enormous vehicular emission and compared with the normal controls living in the residential areas in Delhi.
Methods: Totally, 60 subjects all males and nonsmokers between 30 and 50 years of age were studied, 30 belonged to exposed group comprised of traffic policemen and 30 nonexposed controls. Their BAEPs were recorded using MEB 5200 Neuropack II plus evoked potential recorder (Nihon Kohden, Japan) and evaluation of anthropometric and neuro-psychiatric parameters was done. To compare BAEP results, Student's t-test was used.
Results: Significantly prolonged absolute peak latencies I, II, III, IV, V and IPL I-III in exposed group were observed as compared to controls.
Conclusion: Findings suggest prolongation of peripheral and central auditory conduction time in exposed subjects. The prolonged latencies in exposed group may be attributed to occupational exposure to vehicular emission.

Background and Aim: The ABO blood type, an easily accessible factor in patient's genetic make-up has been associated with many diseases; perhaps the ABO antigens play a role by influencing renin levels. It may be speculated that since blood pressure (BP) is multifactorial, the ABO antigens may indirectly influence arterial pressure. Therefore, in the present study, we intend to assess the relationship between BP and blood group among the male blood donors (20-60 years) attending the blood bank in a tertiary care center.
Methods: Basal cardiovascular parameters such as basal heart rate, systolic BP, diastolic BP (DBP) and rate pressure product (RPP) were recorded. ABO and Rh (D) blood groups were also determined for each subject. Tube test for ABO and Rh typing of red cells and serum typing was done on the donor blood samples.
Results: The test group comprised of 767 subjects within the age-group of 20-60 years. All the values were expressed as mean ± standard deviation with the P < 0.05 as statistically significant. DBP was found to be significantly associated with blood group.
Conclusion: There was a positive correlation between DBP and blood groups, but RPP was not found to be significant between the groups. Hence, we presume that further studies with a population-based screening of various blood groups might help in identifying and modifying the risk factors for hypertension.

Background and Aim: The H reflex is a useful measure of the nerve conduction through the entire length of the afferent and efferent pathways, especially at the proximal segment of the peripheral nerve, which is inaccessible by routine surface stimulating and recording techniques. Therefore, the objective of the present study is to determine the effect of head postural modification on flexor carpi radialis H reflex in healthy subjects.
Methods: This study was done on 40 healthy individuals with a mean age of 22.37 ± 1.23. The H reflex was then recorded by the use of the electromyography machine with the subject in a sitting position. The subjects were asked to maintain 30-s hold into the end range of flexion, extension, rotation (to the right and then to the left), lateral bending (to the right and then to the left), retraction, and protraction of neck. The H reflex amplitude, latency and H/M ratio were measured.
Results: Repeated multivariate analysis of variance was used to evaluate the significance of the difference among the H reflex, amplitude, and latency, in various head positions. Head postural modification does not significantly influences amplitude, latency and H/M ratio in normal healthy subjects.
Conclusion: The H reflex latencies, amplitudes and H/M ratios did not show any significant difference between various head positions when compared with neutral head position.

BackgroundandAim: Though increase in the common bile duct (CBD) diameter has been attributed to previous cholecystectomy, this relationship continues to be controversial. Our objective was to evaluate the relationship between cholecystectomy and change in CBD diameter, as measured by ultrasonography.
Methods: A total of 50 cases (age, 44.0 ± 12.4 years; men, 8; women, 42) were admitted with symptomatic cholelithiasis and normal bile duct diameters. They underwent cholecystectomy, and the CBD diameter was measured by single diagnostician using ultrasonography at the widest point after full-length evaluation of CBD. Follow-up ultrasound at 2 months and 4 months postoperatively was done in all cases.
Results: Mean preoperative CBD diameter observed was 5.12 ± 0.97 mm and mean postoperative CBD diameter observed at 2 months and 4 months interval were 6.79 ± 1.23 mm (32.61% increase; P < 0.0001) and 7.1 ± 1.28 mm (38.47% increase; P < 0.001), respectively. There was a rise in number of patients with CBD diameter of >6.5 mm from nil to 19 (38%) and 25 (50%) at 2 months and 4 months, respectively. CBD dilatation was observed to be age-dependent with mean postoperative diameter increase of 3.37 mm in patients with age >50 years.
Conclusion: The present study confirms that the CBD dilates significantly after cholecystectomy. The postcholecystectomy, CBD diameter does not exceed 10 mm. Thus, a wider CBD following cholecystectomy may warrant further investigation to know the etiology.

Background and Aim: Spirometric parameters are approximated by the normal distribution and using lower limit of normal (LLN) minimize the misclassification with fixed-ratio protocol in interpretation of spirometry results. This study investigates prevalence and characterization of obstructive and restrictive lung function impairments, and dissimilarities between two guidelines interpreting spirometry.
Methods: This study was conducted to assess the lung function in students and patients (n = 74) of MGM Medical College, Kishanganj, Bihar, between September 2012 and May 2014, using computerized Spirometer.
Results: Forced vital capacity (FVC), forced expiratory volume in the 1st s (FEV1)/FVC, forced expiratory flow25-75% (FEF25-75%), peak expiratory flow rate (PEFR) were normally distributed with inflection at their mean ± standard deviation. FEF25-75%, and PEFR were higher in normal individuals compared to individuals with respiratory disease. FEV1/FVC were lower, and FVC were higher in obstructive disease while the reverse results were obtained in restrictive disease category. Restrictive disease by fixed-ratio was found with 55% negative predictive value (NPV) and 5% positive predictive value (PPV), while the normal cases by fixed-ratio criteria was found with 91% NPV and 15% PPV versus LLN criteria. There were 58 individuals with normal spirometries under the LLN method but a discrepant of only 12 fixed-ratio normal results. Concordance analysis by kappa statistics yielded a κ = 0.017.
Conclusion: Older adults are more pulmonary susceptible. The performance of LLN criteria in differentiating respiratory diseases is better than the fixed-ratio criteria. Poor agreement exist between the fixed-ratio and LLN protocols in interpreting spirometric results. There is the difference between the LLN and fixed-ratio criteria which need to be redressed with population-specific reference values.

The stress responses are the hormonal and metabolic changes which occur following injury or trauma. This is part of the systemic reaction to injury which encompasses a wide range of endocrinological, immunological and haematological effects. The present study was conducted to evaluate the serum cortisol, malondialdehyde (MDA) and free fatty acid (FFA) levels in pre and postoperative surgical patients. For the present study, 25 patients admitted in surgical ward for different surgeries were selected. The serum cortisol is estimated by enzyme-linked immunosorbent assay and serum MDA and FFA was estimated by spectrophotometer. On comparative evaluation, there was highly significant decrease (P < 0.001) in the serum cortisol, MDA and FFA levels in the postoperative surgical patients as compared to their preoperative levels. Therefore, from the present study, it could be suggested that serum cortisol, MDA and FFA are associated with the pre and postoperative stress conditions.

Diabetic patients usually present with multiple nerve lesions varying in intensity and distributions among them. Nerve conduction studies (NCS) are usually done for measuring the level of block, type of lesion and aid in diagnostic criteria of polyneuropathies. F waves are usually not done in clinical setting but only on demand from the neurophysician. We present a case of uncontrolled diabetic who had features of carpal tunnel syndrome. He had proximal conduction block (median nerve neuropraxia) with normal sensory distal conduction. Further, antidromic action potentials of F wave analysis confirmed a proximal median nerve lesion rather than distal. We hypothesise that F wave analysis may add to the confirmatory diagnosis of proximal nerve lesions to routine NCS.

Epithelioid angiosarcoma (EA) is a rare, highly malignant tumor that affects mainly the deep soft tissues of the extremities and has a poor prognosis. This angiosarcoma occurs rarely in the middle ear. Herein, we describe an unusual case of 36-year-old man who presented with an 8-year history of progressive left-sided hearing loss and unbearable otalgia for 1-month. Otoscopic examination showed that the left external auditory canal was dry and the tympanic membrane was intacted. An audiogram demonstrated a moderate mixed hearing loss in the left ear. High-resolution computed tomography of the temporal bone demonstrated a huge destructive lesion with significant bone erosion, a round soft tissue mass located mainly in the left mastoid cavity measuring 3.0 cm × 3.4 cm × 3.1 cm, and some soft tissue among the rest of the mastoid air cells and tympanic cavity. The appearance of the lesion did not change with contrast enhancement. Magnetic resonance imaging showed that the soft mass had mixed signal intensity with heterogeneous enhancement on T1- and T2-weighted images and well-defined margins. Histopathology and immunohistochemistry revealed an EA. To our knowledge, this is the first reported case of an EA with clear boundaries located mainly in the mastoid cavity.